Abstract:
INTRODUCTION:Prehospital vital signs are used to triage trauma patients to mobilize appropriate resources and personnel prior to patient arrival in the emergency department (ED). Due to inherent challenges in obtaining prehospital vital signs, concerns exist regarding their accuracy and ability to predict first ED vitals. HYPOTHESIS/PROBLEM:The objective of this study was to determine the correlation between prehospital and initial ED vitals among patients meeting criteria for highest levels of trauma team activation (TTA). The hypothesis was that in a medical system with short transport times, prehospital and first ED vital signs would correlate well. METHODS:Patients meeting criteria for highest levels of TTA at a Level I trauma center (2008-2018) were included. Those with absent or missing prehospital vital signs were excluded. Demographics, injury data, and prehospital and first ED vital signs were abstracted. Prehospital and initial ED vital signs were compared using Bland-Altman intraclass correlation coefficients (ICC) with good agreement as >0.60; fair as 0.40-0.60; and poor as <0.40). RESULTS:After exclusions, 15,320 patients were included. Mean age was 39 years (range 0-105) and 11,622 patients (76%) were male. Mechanism of injury was blunt in 79% (n = 12,041) and mortality was three percent (n = 513). Mean transport time was 21 minutes (range 0-1,439). Prehospital and first ED vital signs demonstrated good agreement for Glasgow Coma Scale (GCS) score (ICC 0.79; 95% CI, 0.77-0.79); fair agreement for heart rate (HR; ICC 0.59; 95% CI, 0.56-0.61) and systolic blood pressure (SBP; ICC 0.48; 95% CI, 0.46-0.49); and poor agreement for pulse pressure (PP; ICC 0.32; 95% CI, 0.30-0.33) and respiratory rate (RR; ICC 0.13; 95% CI, 0.11-0.15). CONCLUSION:Despite challenges in prehospital assessments, field GCS, SBP, and HR correlate well with first ED vital signs. The data show that these prehospital measurements accurately predict initial ED vitals in an urban setting with short transport times. The generalizability of these data to settings with longer transport times is unknown.
journal_name
Prehosp Disaster Medjournal_title
Prehospital and disaster medicineauthors
Trust MD,Schellenberg M,Biswas S,Inaba K,Cheng V,Warriner Z,Love BE,Demetriades Ddoi
10.1017/S1049023X2000028Xsubject
Has Abstractpub_date
2020-06-01 00:00:00pages
254-259issue
3eissn
1049-023Xissn
1945-1938pii
S1049023X2000028Xjournal_volume
35pub_type
杂志文章abstract::Early defibrillation improves survival for patients suffering cardiac arrest from ventricular fibrillation (VF) or ventricular tachycardia (VT). Automated external defibrillators (AEDs) should be placed in locations in which there is a high incidence of out-of-hospital cardiac arrest (OOHCA). The study objective was t...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00001977
更新日期:2004-10-01 00:00:00
abstract::This report describes the main adaptive and transformative changes adopted by the brand-new National Emergency Medical Service (NEMS) to face the novel coronavirus disease 2019 (COVID-19) in Sierra Leone, including ambulance re-distribution, improvements in communication flow, implementation of ad-hoc procedures and t...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X20001211
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:During a mass gathering, some participants may receive health care for injuries or illnesses that occur during the event. In-event first responders provide initial assessment and management at the event. However, when further definitive care is required, municipal ambulance services provide additional assess...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X16001199
更新日期:2017-02-01 00:00:00
abstract::Introduction In the foothills of the Cumberland Mountains, in central Appalachia (a region that spans 13 states in the US), sits an economically distressed and rural community of the United States. Once a thriving coal-mining area, this region now is reported as one of the hardest places to live in the US. Southeaster...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X1600090X
更新日期:2016-12-01 00:00:00
abstract::This report details the background, planning, and establishment of a mass-casualty management area for the Durban Moses Mabhida Stadium at the Natal Mounted Rifles base, by the Department of Health and the eThekwini Fire and Rescue Service, for the Fédération Internationale de Football Association (FIFA) 2010 Soccer W...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X12000453
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Heart failure poses a significant burden of disease, resulting in 2,658 Australian deaths in 2008, and listed as an associated cause of death in a further 14,466 cases. Common in the hospital setting, continuous positive airway pressure (CPAP) therapy is a non-invasive ventilation technique used to prevent a...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章,评审
doi:10.1017/S1049023X12001562
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:To confirm the efficacy of prehospital administration of adenosine, using a 6 milligram (mg) initial dosing regimen, for the treatment of paroxysmal supraventricular tachycardia (PSVT). METHODS:Urban, suburban, rural emergency medical services (EMS) system in Clark County, Washington with advanced life suppo...
journal_title:Prehospital and disaster medicine
pub_type: 临床试验,杂志文章
doi:
更新日期:1997-07-01 00:00:00
abstract:OBJECTIVE:To describe the epidemiology of pediatric emergency medical services (EMS) practice in a large patient population from several geographic areas. DESIGN:Retrospective computer analysis of EMS databases from four states using a common data set and analysis system. SETTING:Pennsylvania, Tennessee, Mississippi,...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00042928
更新日期:1996-07-01 00:00:00
abstract::State governments and hospital facilities are often unprepared to handle a complex medical crisis, despite a moral and ethical obligation to be prepared for disaster. The 2019 novel coronavirus disease (COVID-19) has drawn attention to the lack of state guidance on how hospitals should provide care in a crisis. When t...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X20001405
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND:The objective was to test, in this trauma system, the North American hypothesis that exceeding the 60-minute limit for the entire prehospital time ("golden hour of shock") increases mortality of blunt polytrauma patients. METHODS:In a prospective, observational, cohort study conducted between 1990 and 1996,...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00000212
更新日期:2002-04-01 00:00:00
abstract:INTRODUCTION:Post-injury hypothermia is a risk predictor in trauma patients whose physiology is deranged. The aim of the present study was to examine the effect of simple, in-field, hypothermia prevention to victims of penetrating trauma during long prehospital evacuations. METHODS:A total of 170 consecutively injured...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00000078
更新日期:2002-01-01 00:00:00
abstract:INTRODUCTION:Traditionally, post disaster response activities have focused on immediate trauma and communicable diseases. In developed countries such as Australia, the post disaster risk for communicable disease is low. However, a "disease transition" is now recognized at the population level where noncommunicable dise...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章,评审
doi:10.1017/S1049023X1400137X
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:Little is known about the overall frequency of hazardous materials (HazMat) events in the United States and the nature of prehospital care for those exposed. The purpose of the current study was to perform a descriptive analysis of Emergency Medical Services (EMS) activations reported to a national EMS databa...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X1500504X
更新日期:2015-10-01 00:00:00
abstract::The use of chemical warfare agents against civilians and unprotected troops in international conflicts or by terrorists against civilians is considered to be a real threat, particularly following the terrorist attacks on 11 September 2001 against the World Trade Center in New York and against the Pentagon in Washingto...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章,评审
doi:10.1017/s1049023x00001072
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to describe the injuries and distribution of casualties resulting from the crash of Turkish Airlines flight TK 1951 near Schiphol Airport in the Netherlands on 25 of February 2009. METHODS:This was a retrospective, descriptive study. Based on a review of the hospital records f...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章,评审
doi:10.1017/S1049023X11006467
更新日期:2011-08-01 00:00:00
abstract::In the early morning of 26 December 2003, Bam, an old city in southeastern Iran, was devastated by an earthquake measuring 6.6 on the Richter scale. Managing such situations always brings about many problems. In the case of the Bam Earthquake, two of the most serious problems were rescue operations and provision of ap...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00005355
更新日期:2007-11-01 00:00:00
abstract:INTRODUCTION:This study examines those factors predictive of self-perceived first-aid abilities among a community-based sample after the 1994 Northridge earthquake. METHODS:A probabilities-proportionate-to-size (pps) sample of residents of Los Angeles Country and 11 pre-selected zip codes from southeastern Ventura Cou...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:
更新日期:1997-10-01 00:00:00
abstract:INTRODUCTION:The ever-present risk of mass casualties and disaster situations may result in airway management situations that overwhelm local emergency medical services (EMS) resources. Endotracheal intubation requires significant user education/training and carries the risk of malposition. Furthermore, personal protec...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00007743
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVES:Training students has been proven to be the optimal way to deliver cardiopulmonary resuscitation (CPR) skills. However, it is somehow unknown whether or not the current recommendations appropriate for Caucasian students are also suitable for East Asian students. The purpose of this study is to explore the be...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X1800047X
更新日期:2018-08-01 00:00:00
abstract:INTRODUCTION:Violence against humanitarian health care workers and facilities in situations of armed conflict is a serious humanitarian problem. Targeting health care workers and destroying or looting medical facilities directly or indirectly impacts the delivery of emergency and life-saving medical assistance, often a...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X14000934
更新日期:2014-10-01 00:00:00
abstract:INTRODUCTION:The 2005 Gulf Coast hurricane season was one of the most costly and deadly in US history. Hurricane Rita stressed hospitals and led to multiple, simultaneous evacuations. This study systematically identified community factors associated with patient movement out of seven hospitals evacuated during Hurrican...
journal_title:Prehospital and disaster medicine
pub_type: 历史文章,杂志文章
doi:10.1017/S1049023X13000125
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Prehospital airway management (AM) is the first priority in the care of emergency and trauma victims as it has shown to improve survival in these patients. OBJECTIVE:The aim of this study was to assess training and knowledge of ambulance staff and availability of AM equipment in ambulances of Karachi, Pakis...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X15005385
更新日期:2015-12-01 00:00:00
abstract::A broad range of health problems are related to disasters. Insight into these health problems is needed for targeted disaster management. Disaster health outcome assessment can provide insight into the health effects of disasters. During the 15th World Congress on Disaster and Emergency Medicine in Amsterdam (2007), e...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00021257
更新日期:2008-07-01 00:00:00
abstract:INTRODUCTION:In 2001, the Israeli government announced the construction of the West Bank barrier. The stated purpose of construction to prevent attacks by Palestinians on Israeli citizens. In a subsequent advisory opinion, the International Court of Justice decided the wall would block access to health care and educati...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00004829
更新日期:2007-07-01 00:00:00
abstract::Introduction Previous studies have found that older adults are more likely to use Emergency Medical Services (EMS) than younger adults, but the reasons for this remain understudied. Hypothesis/Problem This study aimed to determine if older age is associated with using EMS for transportation to an emergency department ...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X17000036
更新日期:2017-06-01 00:00:00
abstract:INTRODUCTION:Tenecteplase is a thrombolytic protein drug used by paramedics, emergency responders, and critical care medical personnel for the prehospital treatment of blood clotting diseases. Minimizing the time between symptom onset and the initiation of thrombolytic treatment is important for reducing mortality and ...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X20000928
更新日期:2020-10-01 00:00:00
abstract:INTRODUCTION:Aspirin is administered to patients with acute coronary syndromes (ACSs), but prehospital providers do not administer aspirin to all patients with chest pain that could be secondary to an ACS. OBJECTIVE:To identify reasons prehospital providers fail to administer aspirin to all patients complaining of che...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00003435
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Fibrinolysis is an acceptable treatment for acute ST-segment elevation myocardial infarction (STEMI) when primary percutaneous coronary intervention (PCI) cannot be performed within 120 minutes. The American Heart Association has recommended Emergency Medical Services (EMS) interventions such as prehospital ...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X20000801
更新日期:2020-10-01 00:00:00
abstract::This article describes the basic principles around establishing a Disaster Medicine Camp and the organization of the Ukrainian Disaster Medicine Mobile Hospital, which provided medical aid to victims of the 2001 earthquake in India. All of the information was obtained through direct observation and estimates based on ...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x0000039x
更新日期:2002-07-01 00:00:00
abstract::There is a cascade of risks associated with a hazard evolving into a disaster that consists of the risk that: (1) a hazard will produce an event; (2) an event will cause structural damage; (3) structural damage will create functional damages and needs; (4) needs will create an emergency (require use of the local respo...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X16000285
更新日期:2016-06-01 00:00:00